Alcohol continues to be one of the most commonly used teratogens in the western world, despite the knowledge that exposure in utero can produce Fetal Alcohol Spectrum Disorders (FASD) and an array of other alcohol related effects. In the United States, prenatal exposure to alcohol is one of the leading causes of mental retardation and it is the only cause that is potentially 100% preventable. In recent years, prenatal alcohol exposure has also been found to increase the risk for Sudden Infant Death Syndrome (SIDS). The relationship between prenatal alcohol exposure, SIDS, and FASD is largely unknown. The research described in this application proposes to follow children enrolled in a study on the relationship between Unexplained Stillbirth and SIDS to further investigate the physiological and neurobehavioral outcomes associated with prenatal alcohol use. Through Project EXPORT, the researchers propose to create an infrastructure that allows us to follow the children originally enrolled in the current Safe Passage Study through age 4. This would afford us the opportunity to compare vast amount of information collected on each child during the prenatal and early infancy periods and relate this information to neurobehavioral outcomes that manifest during the toddler and early childhood years. The specific aims of the proposed project include: 1. To identify fetal and infant measurements that are predictive of adverse neurobehavioral outcomes. 2. To investigate the relationship of prenatal alcohol exposure on neurobehavioral outcomes. 3. To identify risk factors for SIDS and explained stillbirth cases (as ascertained through the PASS Research Network) and evaluate the children with the same risk factors who survived through the first year of life. 4. To disseminate results of this research study to all tribes in the Northern Plains region, including information on the following: (1) effects of prenatal alcohol exposure on autonomic nervous system functioning and neurobehavioral outcomes, (2) identify early markers for adverse neurobehavioral outcomes that can expedite early intervention services, and (3) identify contextual risk factors for stillbirth, SIDS, and adverse pregnancy outcomes that may assist in public health prevention efforts.